Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
In Reply: We agree with Dr Moorman that the
magnitudes of the inverse associations we reported are likely to be underestimated
because we relied on self-reports of aspirin use while lacking information
on the use of prescription drugs containing NSAIDs. Using data from Table
2 in the article by Moorman et al,1 we calculated
an unadjusted association of 0.8 between NSAID ever-use and breast cancer
risk if those patients who used prescription NSAIDS only were included in
the referent group. This is of similar magnitude to our estimate and is more
modest than the overall association of 0.5 when those patients who used prescription
NSAIDS only are not included in the referent group. Thus, it is likely that
our results would have shown a stronger inverse effect between breast cancer
and the use of aspirin if we could have excluded the women who used prescription
NSAIDs only from our referent group of nonusers.
Terry MB, Gammon M, Neugut AI. Association of Aspirin Use and Hormone Receptor Status With Breast Cancer Risk—Reply. JAMA. 2004;292(12):1426-1427. doi:10.1001/jama.292.12.1427-a